Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology | 5201002721 | MI |
NPI | 1508374398 |
---|---|
Provider Name | Susan Marie Oblender |
First Address | Ann Arbor, MI 48104-6796 |
Second Address | Ann Arbor, MI 48104-6796 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/01/2018 |
Last Update Date | 16/01/2018 |